Managing arthritis flare ups

How to manage inflammatory arthritis flare-ups

A combination of pain relief treatments and self-management is often the most effective way to manage an inflammatory arthritis flare-up. You may also need to adjust how you do daily tasks, as well making changes in the workplace or at college, until you start to feel better. 

Key facts

  • You may go through periods when your arthritis pain is worse than usual. This is known as a flare-up or a flare. 
  • Flare-ups can happen for no reason, but you may start to recognise some of your triggers. 
  • A combination of approaches and treatments can help you with a flare-up – including medicines, movement, relaxation techniques, rest, and support from others. 
  • If your flare-ups are getting worse or more frequent, your healthcare team may want to review your treatments. 

Am I having a flare-up?

If you have inflammatory arthritis, you may go through periods when your symptoms suddenly become worse than usual. These are known as flare-ups, sometimes shortened to flares. 

The most common forms of inflammatory arthritis are: 

It’s not always easy to tell when a flare-up is starting. You may notice changes in your joints such as swelling, but sometimes tiredness, feeling generally unwell or just feeling ‘off’ for no clear reason may be an early sign.  

Flare-ups can be painful and stressful. They can affect much more than your joints, making it harder to move, work, sleep, think clearly or enjoy life.  

I couldn’t be bothered to lift a cup of tea, to have a shower. Everything was a chore. Everything was getting in the way of normal living.

Mike

What causes arthritis flare-ups?

During a flare-up, inflammation in your body increases. This can make your joints more swollen, warm, painful or stiff. Inflammation can also cause tiredness or make you feel unwell. Some people describe this as feeling like they have flu. 

It’s hard to say for sure what causes arthritis flare-ups. A flare-up does not always happen for a clear reason. It may be triggered by: 

  • an infection 
  • stress 
  • poor sleep 
  • changes to your medicines 
  • a sudden increase in activity at a level your body is not yet used to. 

Although flare-ups can feel alarming, they do not always mean your arthritis is getting worse. Some settle with self-management and your usual treatments, while others may mean your healthcare team needs to adjust your treatments to bring the inflammation back under control. 

How can I look after myself when I’m having a flare-up?

There are things you can do to manage your symptoms and help yourself recover. Use the approaches that work for you and follow the advice from your healthcare team. 

Keep taking your arthritis medicines

Keep taking your prescribed arthritis medicines unless you've been told not to by your healthcare team. This includes disease-modifying anti-rheumatic drugs (DMARDs) and biologic or targeted medicines, which work to control the inflammation that’s causing your symptoms. Stopping these medicines without medical advice may increase the risk of your flare lasting longer or your symptoms getting worse. 

If your healthcare team has given you a flare-up plan, follow it. This may include taking a short course of steroids or making other changes to your treatment for a while. 

Keep moving, but adapt your activities

When your joints are painful, you may feel like doing less exercise. But this can make stiffness worse and make it harder to get moving again. 

Staying active may help reduce inflammation. It can also: 

  • help reduce stiffness 
  • maintain joint movement 
  • keep your muscles strong.

Adapt your activities. Listen to your body. It's normal to do a little less during a flare-up, but aim to stay as active as your symptoms will allow. 

You might want to reduce the intensity or duration of workouts, take more frequent breaks, or choose an activity that feels more manageable. As your symptoms improve, gradually build back up towards your usual level of movement. 

Doing your exercises in warm water can make it easier, for example try doing your hand or wrist exercises with your hand submerged in the sink. 

Your healthcare team or physiotherapist can help you decide how to adapt your exercise safely at times when pain and fatigue are at their worst. 

See our full range of exercise resources: exercising-with-arthritis.

Managing pain during a flare-up

Pain is often one of the first things people want to get under control during a flare-up. Reducing pain can make it easier to keep moving, sleep better and carry on with daily activities. 

The pain doesn’t stay the same – it shifts and changes. It comes and goes with new medications and can persist even when healthcare professionals tell me I’m in remission.

Tom

Pain relief medications 

A lot of people find pain relief, such as paracetamol or anti-inflammatory medicines (NSAIDs), help them manage their pain. 

If you've been prescribed pain medicines for your arthritis, take them as directed. Always read the patient information leaflet and do not take more than the recommended dose. If you're unsure which type of pain relief is suitable for you, speak to your pharmacist, GP or rheumatology team. 

Pain relief helps manage your symptoms, but for most forms of inflammatory arthritis, such as rheumatoid arthritis, it does not treat the inflammation causing the flare-up. 

Looking after painful joints

Some people find that applying warmth to stiff muscles and joints helps them relax and move more easily, while a cold pack can soothe joints. You may find one works better than the other, or that you prefer to use different approaches at different times. 

If you've been advised to use splints or supports during a flare-up, follow the guidance you've been given. They can help support painful joints while allowing you to continue with everyday activities. But prolonged use may weaken the muscles around the joint. 

Small changes, such as choosing supportive footwear, using kitchen gadgets and aids or adapting how you carry out tasks, can also make life more manageable until your symptoms improve. 

Creams and gels for pain

Topical treatments are creams or gels that you apply to your skin. Some people find them a useful way to manage pain in a joint or area during a flare-up, instead of taking pain relief in the form of tablets. 

Topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac gels can help reduce pain and inflammation. They work best on joints that are close to the skin, such as the knees and hands. They’re less likely than NSAID tablets to cause side effects elsewhere in the body, but they’re not suitable for everyone. 

Some people find capsaicin cream helpful for joint and muscle pain. Capsaicin is the substance that gives chilli peppers their heat. It’s thought to affect pain signals from nerves. It works gradually, so it can take several weeks before you notice its effects. 

Warming or cooling creams and gels, including products containing menthol, create a warming or cooling sensation. Some people find this soothes painful joints or muscles, although evidence that they reduce arthritis pain is limited. 

Ask a pharmacist if you’re unsure which topical treatment might be suitable for you. 

TENS

A transcutaneous electrical nerve stimulation (TENS) machine is a small device that sends mild electrical impulses through pads placed on your skin. Some people find TENS helps them manage their pain. 

Evidence for TENS in arthritis is mixed, and it does not work for everyone. But if you find it helpful, it can be used alongside other ways of managing your pain. Follow the instructions that come with the machine and ask a healthcare professional if you’re unsure whether it’s suitable for you. 

Pace yourself

A flare-up can affect your energy as well as your joints. Rather than trying to carry on as normal, or stopping everything, do your best to find a balance: 

  • try to plan ahead 
  • prioritise tasks and events that matter most 
  • break larger jobs into smaller steps 
  • spread activities throughout the day – follow heavy tasks with lighter ones or a rest break 
  • rest before you become exhausted, rather than waiting until you've reached your limit 
  • change position regularly and use a comfy, supported posture to reduce fatigue.
  • if friends or family offer to help, accept it while your symptoms are at their worst. 

For me, a big part of self-management is pacing myself. Pacing comes with trial and error. Sometimes, despite planning ahead, you’re going to exhaust yourself.

Monique

A flare-up may affect your ability to work or study. If possible, let your employer, manager, teacher or tutor know what's going on, and discuss any adjustments that could help. This might include: 

  • flexible working 
  • working from home 
  • changing your duties 
  • taking more breaks 
  • extending deadlines. 

Temporary adjustments can help you stay in work or education while giving your body chance to recover. 

Look after yourself

Inflammation can affect your whole body. So, it's important to look after your general wellbeing as well as your joints. 

Try to: 

  • prioritise sleep and rest 
  • keep moving 
  • eat regular balanced meals 
  • drink plenty of fluids, unless you’ve been advised not to for medical reasons 
  • keep in touch with people who can support you. 

If you're feeling low, anxious or overwhelmed by your flare-up, let someone know. Living with inflammatory arthritis can be a challenge, particularly when symptoms become worse. 

Looking after yourself isn't a luxury during a flare-up. It's an important part of your recovery. 

At Arthritis UK, we have lots of information about how you can look after yourself while living with arthritis. Click here to find out more: living with arthritis.

Keep an eye on your symptoms

Most flare-ups improve over time, but it's helpful to notice how your symptoms are changing. You could keep a flare-up diary to help you track this. 

You may find it useful to keep a note of: 

  • when the flare started 
  • which joints are affected 
  • how long morning stiffness lasts 
  • whether your symptoms are improving, staying the same or getting worse. 

This can help you decide whether you need further advice and can also be useful to discuss with your healthcare team if your flare-up does not settle. 

When should I get medical advice?

Many flare-ups can be managed at home, but sometimes you may need further advice or treatment. 

Contact your healthcare team if: 

  • your pain is not improving or it’s getting worse 
  • your flare-up is lasting longer than usual  
  • you're having flare-ups more often than you used to 
  • you're struggling to manage despite self-management and pain relief  
  • you're needing pain relief medicines more often than usual. 

Your arthritis treatment may need to be reviewed. After reviewing your longer-term treatment, your healthcare team may discuss short-term treatments to help bring the inflammation under control more quickly.  

Depending on your symptoms, these could include a short course of steroid tablets or a steroid injection into a joint. These treatments can provide rapid relief while your flare settles or longer-term treatment takes effect, but they are usually only offered after an assessment by a healthcare professional. 

Pain and fatigue can affect many aspects of daily life. You can find more advice and practical tips in our information on: 

Seek urgent medical advice if you have a suddenly very hot, swollen joint. This could be a sign of an infection that needs urgent treatment. You may also have a fever or feel generally unwell with it. 

Preparing for future flare-ups

Although you cannot always prevent a flare-up, being prepared and knowing your triggers can make it easier to manage and help you recover more quickly. 

Once your symptoms have settled, take a little time to think about what may have contributed to your flare-up. Some people notice patterns over time, such as symptoms getting worse after an illness or doing more than usual, periods of stress or changes to their routine. Recognising these patterns may help you spot the early signs of a flare-up and feel more prepared in the future. 

Some people find it helpful to have a flare-up plan. This may include: 

  • the medicines you should take 
  • the self-management strategies that usually help  
  • who to contact if your symptoms get worse  
  • when to seek medical advice.  

It can also help to think about practical ways to make life easier if a flare-up happens. You may want to: 

  • keep a few easy-to-prepare meals in the freezer or cupboard  
  • make sure you don't run out of your regular medicines  
  • keep useful items, such as heat or cold packs, splints or supports, somewhere easy to reach  
  • save key contacts, such as your GP, rheumatology team or specialist nurse, in your phone  
  • think about who could help you with shopping, childcare or household tasks if you need extra support  
  • if you work, study or care for others, think about what adjustments might help if a flare-up affects your usual routine.  

Putting together a flare-up kit

You might find it helpful to put together a small flare-up kit with things you know can help when your symptoms get worse. This can be particularly useful when you’re travelling or away from home. 

You could include any medicines you’ve been advised to use during a flare-up, a heat or cold pack, any supports or aids you find helpful, and details of who to contact if you need medical advice. 

As your flare-up settles, you may not get back to normal straight away. Try to continue to pace yourself while you recover. 

Discover our support services  

You don’t need to face arthritis alone. Get the information, advice and support that you need. 

Sources 

  • NICE – Rheumatoid arthritis in adults: management (NG100)  
  • NICE – Spondyloarthritis in over 16s: diagnosis and management (NG65)  
  • NICE – Juvenile idiopathic arthritis in under 16s: diagnosis and management (NG79)  
  • British Society for Rheumatology (BSR) – Pain management in people with inflammatory arthritis (2026)  
  • European Alliance of Associations for Rheumatology (EULAR) – Recommendations for self-management in inflammatory arthritis 
  • Secondary sources [Internal reference only] 
  • University Hospitals Plymouth NHS Trust. Rheumatology patient information on managing arthritis flare-ups. 
  • National Rheumatoid Arthritis Society (NRAS) – Managing flares in rheumatoid arthritis 
  • Arthritis Action. Flare Up Planning. 2023. 
  • Arthritis Foundation. What Causes an Arthritis Flare-Up? 2024.